Why does IQWiG work in accordance with the principles of evidence-based medicine (EBM)?
Evidence-based medicine (EBM) is an important basis of the Institute's work. It denotes health care that is not based solely on personal opinions and conventions, but on proof (evidence). This proof should be obtained using the most objective scientific methods possible and provide reliable results.
EBM in practice
In everyday practice, this means that doctors do not rely solely on individual practical experience, but also consider the results of current scientific research in their treatment recommendations. Combined with their experience, this allows them to decide on a tailored treatment for the patient based on the best possible knowledge.
At IQWiG, it is not an individual case that prompts scientific research, but rather the question of the benefits or harms of medical interventions for patients. The Institute then systematically searches the international medical and scientific literature for evidence of the benefits of the intervention based on this question.
How is a benefit assessment conducted according to EBM criteria?
In general, an evidence-based benefit assessment in health care involves the following steps:
- Formulation of the research question using the PICO formula: patient, intervention, comparison, outcome
- Search of the medical literature
- Extraction and evaluation of information. This includes describing the methods and results of the studies identified in the literature search, and undertaking a methodological assessment of the reliability of results and the transferability to the actual healthcare context.
- Synthesis and final evaluation of all documents considered
These steps are always carried out systematically and are therefore reproducible.
Fundamental aspects of benefit assessments explained simply
IQWiG's methods are described in detail in its methods paper. But why does IQWiG work the way it does? What is so important about a direct comparison? And what exactly is the appropriate comparator therapy? We explain these and other aspects of our methods briefly on these pages.
Why does IQWiG use EBM?
The aim of evidence-based medicine is:
- to provide answers to medical questions, such as whether one treatment has more benefit than another, in a structured and systematic way.
- to provide high reliability of results for decision-making. A standard element of EBM is to carry out a systematic search and synthesis of all studies of appropriate quality on a question. This summarizes the current state of knowledge.
- to guard against wrong decisions and false expectations. For example, by avoiding situations where beneficial treatments are not included in the provision of health care or where non-beneficial treatments can harm patients.
All these aspects are important to IQWiG. The Institute's reports are often the basis of policy decisions by the Federal Joint Committee (G-BA). This means that IQWiG's recommendations must be scientifically reliable.
Evidence-based medicine allows an assessment of how reliable the available knowledge on an examination and treatment method really is. Furthermore, it allows an assessment of where reliable data are missing. This aspect is often just as important in the provision of health care because only when gaps in knowledge are discovered, can targeted research be conducted in these areas.